Cyclical Vomiting Syndrome Treatment
What is Cyclical Vomiting Syndrome?
Cyclical Vomiting Syndrome (CVS) is characterised by periods of severe vomiting, followed by periods symptom-free periods, or periods of remission. While the symptoms may completely disappear throughout remission, its is possible that they may linger as more mild symptoms. CVS sufferers will vomit at least 4 times in one hour during an attack, with attacks lasting anywhere from 1 hour up to 10 days [1, 2]. Due to the length of time and intensity of these attacks, it can leave sufferers experiencing dehydration [2]. While CVS is most commonly experienced in children aged 3-7, it is also reported in adults.
CVS is considered a migraine-like condition, as it has been associated with sensitivities in the central nervous system.
Symptoms
The most common signs and symptoms of CVS are [1, 2]:
- Recurrent vomiting, lasting up to 1 week
- Severe nausea
- Intense sweating
These associated features may also be present:
- Abdominal pain
- Diarrhoea
- Fever
- Dizziness
As the symptoms of CVS are similar to several other conditions, it is often mid-diagnosed.
While CVS is considered to be a “migraine disorder”, it is rarely associated with headaches. This is due to attacks including headaches being classified as “classic” or “common” migraine.
Abdominal Migraine vs Cyclic Vomiting Syndrome
Due to the similarities in symptoms between CVS and abdominal migraines, they are often considered the same condition [2]. However, there are some key differences.
CVS relates to intense bouts of nausea, vomiting and other stomach related symptoms, lasting up to 10 days. Comparatively, abdominal migraines last for 3 days. Also, while it is possible for people experiencing abdominal migraines to experience nausea and vomiting, it is most commonly just experienced as abdominal pain. Both VCVS and abdominal migraine sufferers experience a loss of appetite and pale skin during an attack.
In both cases, sufferers can experience loss of appetite and pale skin during an attack.
What is the cause of Cyclical Vomiting Syndrome?
There are many different theories about the cause of CVS. Some suggest that chemicals such as, histamines and serotonin are involved. Other theories include genetic differences or hormone imbalances. There seems to be a strong link in children who suffer from CVS, to developing Migraines later in life. Because of this there it is proposed that CVS is a form of migraine. One of the reasons it can be hard to establish a cause, is that children have a hard time differentiating between CVS, abdominal migraines and stomach flu. As such, it is important to rule out these differentials, as well as Irritable Bowel Syndrome, gastroenteritis and appendicitis.
It is common for sufferers of CVS to present with no identifiable pathology. In these cases, a sensitised brainstem may be the true cause.
Modern research suggests that dysfunction in the cervical spine, resulting in a sensitised brainstem can lead to a wide variety of symptoms. In the case of CVS, this over sensitive brainstem would determine low-level inputs, such as eating certain food, as a threat and trigger a reaction of aggressive vomiting and pain. It is this vicious relaying of information that CVS sufferers experience.
I’ve tried it all, is there anything else that I can try?
Most of our patients who suffer from CVS have tried a wide range of different treatments. Many have gone through a spectrum of medications, including; over-the-counter painkillers, triptans or even anti-depressants. It isn’t uncommon for sufferers of CVS to have seen multiple doctors and specialists. Sometimes these methods can alleviate the symptoms, but in many cases, nothing seems to work.
This is where The Headache and Migraine Clinic comes in, we are specially trained to assess both the cervical spine and the brainstem in order to establish if they are in fact, the true cause of your symptoms. If this is the case, then we can start treatment right away. We work to correct the dysfunction in your neck and desensitise the brainstem using our modern, world leading techniques. The best thing is that the treatment is safe, gentle, medication free and non-invasive!
Imagine living a life free from headaches and migraines and saying goodbye to medications!
To gain your recovery today contact us on 1800 HEADACHE (toll free)
1800 43 23 22
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Accurately diagnose your condition for effective treatment
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Phase 3
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What are Cluster Headaches?
Cluster Headaches are a rare type of headaches that affect around 0.1% of the population, according to the International Headache Society. While they are rare, it does affect males 3-4 times more frequently than females [1].
Despite being uncommon, Cluster Headaches are regarded as being the most severe and debilitating type of headache. Research has shown Cluster Headaches frequently described as having the highest pain levels [2], out of all 300 different types of headache and migraine. Cluster Headache attacks occur in cycles, and will often wake sufferers during the night, or at regular times during the day. Attacks generally last between 15-180 minutes, and can happen multiple times per day, or once every couple of days [1, 2]. People who suffer from Cluster Headaches generally experience periods of attacks, or “cluster periods” that can last weeks or months. These periods are then followed by periods of remission lasting weeks, months or even years. The pain is often severe, on one-side of the head, and generally around the eye and/or temple region. Cluster Headaches have adopted the nickname, ‘suicide headaches’ due to their severe and debilitating nature [2].
What are the signs and symptoms?
Cluster Headaches are often severe enough that a sufferer cannot keep still during an attack. They may pace back and forth, have to take a shower, or even resort to banging their head in an attempt to reduce the pan.
Symptoms commonly associated with Cluster Headaches include [2]:
- Severe pain around one eye, that can radiate further around the face or neck
- Restlessness, shortness of breath and/or a sweaty face
- Watery/teary eyes or eye redness
- Swollen or droopy eyelids
- Runny or congested nose
- Pale or flushed skin
- Pain is unilateral, or affects only one side
What are the different types of Cluster Headache?
There are 2 types of cluster headache.
Episodic Cluster Headache
Cluster Headaches most commonly occur episodically. This is when sufferers experience bouts of “cluster periods” that can last for weeks or months, followed by an extended period in remission that can last up to years. They can occur seasonally or at set times each year. Episodic Cluster Headaches account for up to 80% of all Cluster Headaches [1, 2].
Chronic Cluster Headache
When Cluster Headaches occur without a prolonged period of remission, they are termed a Chronic Cluster headache. Sufferers often have “cluster periods” that will last over a year. While they may have days without attacks, the remissions will not last longer than a month.
What are the risk factors?
- Men are 5-6 times more likely to experience cluster headaches
- Sufferers are generally heavy smokers
- Higher alcohol consumption may be a factor
- Cluster Headaches most commonly affect people aged 20-50, but can occur at any age
- People with family members who are sufferers may be at a higher risk
What causes Cluster Headaches?
Historically, it was believed that cluster headaches, as well as migraines, were caused by the dilation of blood vessels in the head, causing pain. This was thought because medications, like triptans, are effective at relieving the pain if taking early enough in an attack. It was believed that triptans prevent this vessel dilation. However, recent research has shown that Cluster Headache and migraine sufferers do not experience blood vessel dilation at any different levels to people who do not suffer. So, how do these medications work?
Modern research has shown that Cluster Headaches and migraines arise from increased sensitivity in the central nervous system [2], more specifically, a sensitised brainstem which is located in the upper cervical spine (the upper neck). Faults in the upper neck can lead to this sensitised brainstem, which then can refer severe pain and associated symptoms into the head and face [3]. Triptan medication has also more recently been shown to de-sensitise the brainstem [4], as well as its original purpose of constricting blood vessels in the head. This would explain why they work, as well as identifying a sensitised brainstem and the cervical spine as a cause of cluster headaches.
I've tried it all, is there anything that can help me?
While Cluster Headaches are very uncommon, they are still experienced in the Gold Coast region. The severity of symptoms causes sufferers to try a range of therapies in an attempt to resolve them, with mixed results. Often, they have tried; medications, injection therapy, or even surgical interventions such as, nerve blocks or blood vessel cauterisation.
At The Headache and Migraine Clinic, we aim to use the most modern research to find the root cause of your cluster headaches. If we can determine that a sensitised brainstem is the cause of your headaches, then we can use world-leading treatment techniques to address the faults in your neck and de-sensitise the brainstem. We have seen plenty of Cluster Headache sufferers at our clinics, and have an 85-90% success rate with our treatment technique. The best part is that it is safe, non-invasive and medication-free.
